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4800 Mental Health Commitment

APS-IH / February 2009

When a person becomes seriously mentally ill, temporary hospitalization at an in-patient psychiatric hospital may be the recommended treatment. A person may enter a psychiatric hospital voluntarily. However, a person has a right to refuse treatment. 

See Texas Health and Safety Code §574.034.

Basis for Commitment

A person who refuses hospitalization may be committed to a court-ordered hospitalization, if the person is found to be mentally ill to the degree that there is a substantial risk of serious harm to himself or herself or to others unless the person is immediately restrained.

Lengths of Hospitalizations

All court-ordered commitments are temporary, lasting for a period of up to 90 days.  Within that 90-day period, the treating physician at the hospital determines when the patient’s illness has stabilized sufficiently for the patient to be released. Most commitments last a month or less.

If the physician determines that the patient needs a commitment for longer than 90 days, the hospital seeks a second 90-day commitment. In very rare cases, a patient may need lengthy hospitalization. In this event, the hospital seeks an extended court-ordered hospitalization.

Due Process

Because a court-ordered hospitalization is a significant infringement on a person’s constitutional rights, due process of law is required.

A patient is entitled to a full trial before a jury, legal representation, and the right to cross-examine all witnesses. Since the patient may be uncooperative, the law provides a process permitting the patient to be taken into custody and detained for psychiatric examination and protection until the trial can be held on the temporary order.

Out-Patient Treatment

In the hearing, the judge or jury may find that the patient must participate in out-patient treatment rather than in-patient (hospitalization) treatment. This seldom occurs because compulsory out-patient treatment is very difficult to enforce.

4810 Emergency Detention

APS-IH / February 2009

An emergency detention warrant may be issued by a judge to obtain a medical assessment to determine whether a client needs court-ordered hospitalization. The warrant is carried out by law enforcement.

If there is no time to get a warrant, law enforcement may:

  •   take the client into custody; and

  •   transport the client to a mental health facility for assessment.

In order for a judge to grant a warrant for emergency detention, law enforcement must:

  •   witness the client's behavior or circumstances; or

  •   be informed of the behavior or circumstances through a report made by a credible person. The APS specialist is a credible source of information for law enforcement.

An emergency detention warrant may be issued if the client must be immediately restrained because he or she exhibits behavior that is a current threat to the life of the client or another person.

Clients detained in a mental health facility must be examined by a physician within 48 hours of detention. If the physician does not certify the need for further detention pending a probable cause hearing, the client must be released.

Law enforcement provides transportation for the client when carrying out an emergency detention warrant. In no circumstances does the APS specialist transport the client.

4811 Emergency Detention for an APS Client

APS April 2019

An emergency detention warrant may be necessary in cases where both of the following apply:

  •   The client refuses to see a physician.

  •   The client’s actions meet all of the following criteria:

  •   APS believes the actions are related to mental illness.

  •   The actions show a substantial risk of serious harm to the client or others.

  •   The actions show that harm is likely to happen soon unless the client is immediately restrained.

In these cases, the APS specialist does as follows:

  •   Obtains the supervisor’s approval, if possible, before notifying law enforcement or mental health officials about the need for an emergency detention.

  •   Contacts local law enforcement, a peace officer, or a mental health officer, and asks the officer to take or arrange for action to protect the client and others from serious harm.

  •   Contacts local mental health staff to obtain and document the results of the client’s evaluation.

  •   Contacts local mental health staff to obtain and document the results of the court hearing, if the client is detained or committed to a facility for evaluation.

  •   Consults with the supervisor and the risk subject matter expert about whether APS should do either of the following:

  •   Provide further services.

  •   Continue to monitor the client’s status.

When Law Enforcement Requests That APS or an Individual Seek an Order for Emergency Detention

Law enforcement may request that APS or an individual apply for an emergency detention order, rather than law enforcement seeking the order directly. The APS specialist may file an application for emergency detention if no one else is available to do so. This application asks the court to issue an emergency detention warrant, which directs law enforcement to detain a specific person.

The APS specialist contacts the local court to request the application form to apply for an emergency detention warrant. The specialist completes the application, which includes a detailed description of the following:

  •   The applicant’s relationship to the client.

  •   The client’s specific behavior, acts, attempts, or threats.

  •   The specific risk of harm.

The APS specialist provides the completed application to the judge or magistrate. This court official determines whether an emergency detention warrant is necessary and, if so, how that warrant will be delivered to law enforcement for them to carry it out.

The court may request that APS deliver the warrant to law enforcement. If the court does this, the APS specialist does as follows:

  •   Delivers the warrant.

  •   Consults all of the following people before taking any further action:

  •   Supervisor

  •   Program administrator

  •   Regional attorney

The APS specialist does not do the following:

  •   Carry out the warrant himself or herself.

  •   Transport the client.

The law allows any adult with knowledge of the facts to apply to a court to request that the court issue an emergency detention warrant. However, law enforcement usually files the application for the warrant.

If law enforcement has not asked APS to file the application, the APS specialist consults with the following people:

  •   Supervisor.

  •   Subject matter expert.

  •   Regional attorney, if possible.

The purpose of consulting them is to determine whether this action (APS filing the application) is available and appropriate in the county where the client lives.

Texas Health and Safety Code §573.011

4812 Documentation for Emergency Detentions

APS IH September 2014

The APS specialist documents:

  •   consultations with the supervisor in contact detail narratives;

  •   the interviews with any collaterals in contact detail narratives; and

  •   the detention on the IMPACT Legal Action page.

4820 Temporary Court-Ordered Mental Health Services

APS-IH / February 2009

If the doctor’s statement indicates that the client meets the statutory criteria for court-ordered commitment:

  •   it is attached to an application for temporary commitment; and

  •   filed with the probate court.

A second doctor’s statement must be obtained to support the first.

The court appoints an attorney ad litem to represent the client. 

The county attorney represents the applicant. After a full hearing, held within 14 calendar days of the filing of an application for court-ordered mental health services, a county court may issue an order for temporary mental health services for up to 90 calendar days. If the client requests it, a jury trial is held. 

If the client needs to be detained until the hearing on the temporary commitment can be held, an order for protective custody is requested. Detention pending the hearing is at a hospital.

The judge may order an individual to receive court-ordered mental health services only if the judge or jury finds, from clear and convincing evidence, that an individual is mentally ill and:

  •   is likely to seriously harm himself or herself, or others, as a result of that mental illness; or

  •   is suffering severe and abnormal mental, emotional, or physical distress; and

  •   has a condition that will progress to the point that the individual cannot care for himself or herself; or

  •   is unable to make a rational and informed decision as to whether or not to submit to treatment.

If the APS specialist does not attend the hearing, the APS specialist contacts the local mental health authority staff for the results of the hearing and if the client has been committed, the name of the hospital.

The APS specialist contacts that hospital’s social worker for assistance in planning for the client’s release. A mental health commitment should always be regarded by an APS specialist as a short term placement for the client. Planning for assisting the client when he or she leaves the hospital should begin at once.

See Texas Health and Safety Code §574.034.

4830 Voluntary Admission to a Mental Health Facility

APS-IH / February 2009

For voluntary admission, the client must file a statement with the director of the mental health facility. A hospital staff person informs the client orally and in writing of the client’s rights as a voluntary patient. The client must agree to submit to the facility's custody for diagnosis, observation, care, and treatment until the client is discharged or until 96 hours after filing a written request for release with the facility's director. If the client does not withdraw the request for release, further detention is involuntary and requires a court order.

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